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Daily Vehicle Inspection Report <br /> First Choice Medical Transport,LLC <br /> Date: Check-in Time: Unit#: <br /> Crew Members: <br /> Pre-Trip Vehicle Checklist: <br /> Starting Odometer Mileage: Gas Gauge: E - - 1/4 - - 1/2 - - 3/4 - - F <br /> 02 tanks (E) Lrg PSI: , 02 tanks (D) Sm PSI: <br /> 1. Check tires for inflation,wear or danger spots. good see comments <br /> 2. Look under the vehicle for puddles and/or leaks. good see comments <br /> 3. Check belts and hoses. good see comments <br /> 4. Check fluid levels. good see comments <br /> 5. Ensure that all lights are functioning. good see comments <br /> 6. Check siren/horn. good see comments <br /> 7. Confirm that PPE gear is available/adequate. good see comments <br /> 8. Check AED and Suction for proper charge. good see comments <br /> 9. Check medical supply inventory good see comments <br /> (confirm that required items are present and functioning) <br /> Comments: <br /> Post-Trip Vehicle Checklist: <br /> Ending Odometer Mileage: Gas Gauge: E - - 1/4 - - 1/2 - - 3/4 - - F <br /> 02 tanks (E) Lrg PSI: , 02 tanks (D) Sm PSI: <br /> 1. Dispose used PPE items. [ <br /> 2. Clean and disinfect the patient compartment& all used equipment [ ] <br /> 3. Dispose all contaminated single-use medical supplies and disposable cleaning supplies. [ ] <br /> 4. Ensure that all equipment is returned to its proper location. [ ] <br /> 5. Prepare the wheeled stretcher for the next patient and lock into place. [ ] <br /> 6. Bag or Exchange dirty linens. [ ] <br /> 7. Complete end-day inventory and list supplies needed in comments below [ ] <br /> 8. Place all patient paperwork in expanding file folder - private information [ ] <br /> Comments/Supplies needed: <br /> Signature: Print: Check-out Time: <br /> Signature: Print: Check-out Time: <br />